Protstatis may account for up to 25 percent of all office visits by young and middle-age men for complaints involving the genital and urinary systems. The term prostatitis actually encompasses four disorders:

• Acute bacterial prostatitis is the least common of the four types but also the easiest to diagnose and treat effectively. Men with this disease often have chills, fever, pain in the lower back and genital area, urinary frequency and urgency often at night, burning or painful urination, body aches, and a demonstrable infection of the urinary tract, as evidenced by white blood cells and bacteria in the urine. It is treated with an appropriate antibiotic.

• Chronic bacterial prostatitis is also relatively uncommon. It is acute prostatitis associated with an underlying defect in the prostate, a focal point for bacterial persistence in the urinary tract. Effective treatment usually requires identifying and removing the defect and then treating the infection with antibiotics. However, antibiotics often do not cure it.

• Chronic prostatitis/chronic pelvic pain syndrome is the most common but least understood form of the disease. It is found in men of any age; symptoms go away and then return without warning. Chronic prostatitis/chronic pelvic pain syndrome may be inflammatory or noninflammatory. In the inflammatory form, urine, semen, and other fluids from the prostate show no evidence of a known infecting organism but do contain cells the body usually produces to fight infection. In the noninflammatory form, no evidence of inflammation, including infection-fighting cells, is present.

• Asymptomatic inflammatory prostatitis is the diagnosis when the patient does not complain of pain or discomfort but has infection-fighting cells in his semen. Doctors usually find this form of prostatitis when looking for causes of infertility or testing for prostate cancer.